text: Naloxegol is a polyethylene glycol-modified derivative of α-naloxol. Naloxegol has a similar form as naloxone as a heteropentacyclic compound both of which have an allyl group attached to the amine of the piperidine ring. However, naloxegol has a monomethoxy-terminated n=7 oligomer of PEG connected to the 6-alpha-hydroxyl group of ɑ-naloxol via an ether linkage. The PEG moiety increases the molecular weight and therefore restricts the uptake of naloxegol into the CNS. Furthermore, pegylated naloxegol becomes a substrate for the P-glycoprotein efflux transporter that transports the compound out of the CNS.